Epigastric Pain Flashcards
Epigastric Pain
Western Medical Diagnosis
8 Points
- carcinoma of esophagus
- gastritis
- gastric ulcer
- carcinoma of ST
- duodenal ulcer
- pancreatitis
- cancer of pacreas
- gall stones
Red Flags
Perforated Gastric Ulcer
3 Points
- sever pain spreading over abdomen
- reluctant to move
- ‘don’t touch me’
Red Flags
Actue Pancreatitis
2 Points
- pain relieved by sitting up and leaning forward
- pain radiates to back
Red Flags
Epigastric Pain
3 points
- vomitting blood
- Severe pain
- balck stool looks like coffee grinds
Nature of pain
Severe
Excess
Nature of pain:
Dull
Deficiency
Nature of pain:
Stabbing
Blood Stasis
Nature of pain:
Burning
Heat
Nature of pain:
Feeling of fullness
Dampness
Nature of pain:
Morning Pain
Deficiency
Nature of pain:
Afternoon Pain
Qi Stagnation
Nature of pain:
Pain at Night
Blood stasis
Aggravating / Alleviating Factors:
Better after eating =
Worse after eating =
Deficiency
Excess
Aggravating / Alleviating Factors:
Better with pressure =
Worse with pressure =
Deficiency
Excess
Aggravating / Alleviating Factors:
Better with heat =
Cold
Aggravating / Alleviating Factors:
Better with rest =
Better with slight exercise =
Deficiency
Qi and Blood stagnation
Aggravating / Alleviating Factors:
Better after vomitting =
Worse after vomitting =
Excess
Deficiency
Taste:
Sticky =
Bitter =
Sweet =
Sour =
No taste =
Dampness
Heat
Damp - Heat
Food Retention
Sp Deficiency
Etiology:
Blockage in ST
↙️↘️
(6)Excess Deficient (2)
What are the 6 Excess Conditions?
Blood Stasis
Phlegm Fluids
Food Retention
Cold
LR over acting ST
Fire / Damp Heat / Phlegm - Fire
Etiology:
Blockage in ST
↙️↘️
(6)Excess Deficient (2)
What are the 2 Deficient Conditions?
Yin XU
Yang XU
Patient was exposed to cold and or eats raw food and smoothies:
Acute, severe, sudden onset. Epigastric pain, worse with cold, better with heat.
What Excess Pattern do they have?
6 Points
ST21, ST34, CV12, PC6, SP4, Moxa
Cold invading the ST
Cold obstruct flow of ST qi and prevent it from discending
Patient was hungry at lunch, consumed his lunch and his friends too.
Distension pain, fullness of epi and ab. Foul gas / breath with acid reflux.
What Excess Pattern do they have?
6 Points
Lineiting, ST44, ST21, CV10, PC6, ST36
Retention of Food
Discending of ST Qi is impared/ stagnant
Patient’s a high powered lawyer who eats on the go, often while standing
Epigastric pain, distension radiating to hypochondrium, onset associated with emotional stress.
What Excess Pattern do they have?
6 Points
LR14, CV12, GB34, PC6, ST36, LR3
LR Qi invading ST
Stress/Anxiety impairs fx of LR. LR over acts on ST, Qi flow is obstructed.
Patient eats spicy lamb dishes. Home life is busy and he rages sometimes
Burning epigastric pain, bleeding gums, vomitting blood, thrist, sour regurgitation, constipation.
What Excess pattern do they have?
5 Points
ST44, ST21, SP6, CV13, BL21
ST Fire
Heat is drying digestive tract and pushing blood out of vessels.
Pateint eats one large meal a day an prefers deepfried food with spice
Feeling of oppression in epigastrium, burning pain, dry mouth, no desire to drink, mucus in stool, red face, manic behavior, mouth ulcers.
What Excess pattern does he have?
5 Points
CV12, ST44, ST40, ST21, PC7
ST Phlegm Fire
Phlegm fire is caused by qi stagnation turning to heat with the addition of dampness from diet or constiution
Patient enjoyes drinks with friends after work to de stress
Dull epigastric pain, dry mouth with no desire to drink, bitter sticky taste in mouth, frontal headache, oppression in the chest.
What Excess pattern do they have?
6 points
BL20, SP9, BL21, SP6, CV12, ST21
ST Damp Heat
stress and diet can cause qi to stagnate gathering dampness and turning to heat.
Patient plays baseball and got hit in the stomach with a pitch
Stabbing pain with fixed location in epigastrum, vomitting blood, black stools.
What Excess pattern do they have?
8 Points
CV12, ST36, PC6, SP4, ST21, ST34, SP10, BL17
Blood stasis in ST
blunt trauma to abdomin may have caused internal bleed causing qi and blood stasis.
Patient has always felt cold and does not warm easily.
Dull indistinct ST pain, increases in pain when stomach is empty, regurgitation of clear fluids, pain improves with pressure
What Deficiency Pattern do they have?
8 Points
BL20, BL21, CV12, CV6, ST36, PC6, SP4, Moxa
ST and SP yang xu
yang xu is deficiency of organ fx. Can be from constitution, EPI or diet.
Patient was taking prescription drugs for over 3 months
Has dry mouth, with desire to drink little sips, dry throat, dull epigastric pain, feeling of heat with mental restlessness and dry stool
What deficiency pattern do they have?
6 Points
BL20, BL21, CV12, ST, 36, SP6, KD3
Stomach Yin XU
Pharmasutical drugs can damage ST yin, can also be from diet, stress or EPI
Etiology
Eipgastric Pain
6 Points
EPI
Diet
Emotional Problems
Over exertion / Overwork
Consitiutional Weakness
Wrong treatment
